B bon fhir_workshop

BlueButton On FHIR

Mark Scrimshire HHS/CMS Entrepreneur-In-Residence @ekivemark

Direct to the Consumer-Powered Health Revolution

A"Baptism"of"FHIRConfirmation

@ekivemark

DisclaimerThe views expressed in this presentation are my own personal views and should not be construed as an official position of the US Department of Health and Human Services or the Centers for Medicare and Medicaid Services.

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R LESHHSEntrepreneur -in-Residence

Medyear CTO &Co-Founder

HealthCa.mp Chief Instigator

Ski Instructor

Big Data & Cloud Technologist

Health & Social Data Ninja

@ekivemark

R LESHHSEntrepreneur -in-Residence

Medyear CTO &Co-Founder

HealthCa.mp Chief Instigator

Ski Instructor

Big Data & Cloud Technologist

Health & Social Data Ninja

@ekivemark

@ekivemarkhttp://healthca.mp

Blue Button Unleashes Personal Data

http://healthca.mp

2010

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1.2MUnique Medicare Members

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There are big opportunities

54,000,000Medicare Beneficiaries (2014 est.)

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An Essential First Step

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…but it left the patient to do the heavy lifting

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https://leicalady.files.wordpress.com/2010/08/annie@[email protected]

People don’t want their data for it’s own sake…

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Our Health data should be a valuable toolwe put to good use

http://commons.wikimedia.org/wiki/File:Toolbox_(6788494881).jpg

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A decision without Information…

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A Tipping Point is coming…

Consumer Industry

RetailPHR

Devices

Genome

EHR

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EIRPIF

USDS

Fast Health Interoperability Resources

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@ekivemark

What"is"• A"Standards"Developing"Organization"• Accredited"by"the"American"National"Standards"

Institute"(ANSI)"• Author"of"consensus@based"standards"• Representing"a"broad"view"from"healthcare"

system"stakeholders

HL7"compiled"a"collection"of"message"formats"and"related"clinical"standards"that"loosely"define"an"ideal"presentation"of"clinical"information

• Adoption"of"version"3.0"since"2005" drove"a"“reset”"in"the"HL7"Community"

• FHIR"is"the"result"of"that"“reset”"http://www.corepointhealth.com/whitepapers/evolution4hl7

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ARGONAUTWhat"is"the"Industry"doing"with"FHIR? athenahealth Beth Israel Deaconess Medical Center Cerner Epic Intermountain Healthcare Mayo Clinic MEDITECH McKesson Partners HealthCare System

SMART (Boston Children's Hospital Informatics Program) The Advisory Board Company

http://hl7.org/implement/standards/fhir/2015Jan/argonauts.html

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What"is"FHIR?

Secure"Transport

Developer"Friendly

Structured"Data

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FHIRThink"of"it"as"an"International"common"Language"for"Health"

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FHIR"Can"Publish"and"Consume"Data

PROFILE

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What"can"a"FHIR"Server"Do?

• Its"all"in"the"Conformance"Statement

http://fhir.bbonfhir.com:8080/fhir@p/ baseDstu2/metadata/ $everything

?_format=json"

@ekivemark

" "{""""""resourceType":"Conformance",""""""publisher":"Not"provided",""""""date":"2015@09@02T15:19:48@04:00",""""""software":{""""""""""name":"HAPI"FHIR"Server",""""""""""version":"1.0@SNAPSHOT""""""},""""""implementation":{""""""""""description":"UHN"Test"Server"(DSTU2"Resources)""""""},""""""fhirVersion":"0.5.0",""""""acceptUnknown":false,""""""format":[""""""""""application/xml+fhir",""""""""""application/json+fhir""""""],""""""rest":["

Conformance:""What"and"How

• JSON"or"XML"Description"of"the"Data"Profiles"and"the"Actions"each"profile"supports

interaction":["""""""""""""""""""""""""{"code":"vread”},"""""""""""""""""""""""""{"code":"update”},"""""""""""""""""""""""""{"code":"delete”},"""""""""""""""""""""""""{"code":"history@instance”},"""""""""""""""""""""""""{"code":"validate”},"""""""""""""""""""""""""{"code":"history@type”},"""""""""""""""""""""""""{"code":"create”},"""""""""""""""""""""""""{"code":"search@type”"}]

GET"http://localhost:8080/fhir@p/baseDstu2/Practitioner/32768"

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Building"BlocksPrimitives

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Constructing"Resources

• Identifier"• HumanName"• Address"• ContactPoint"• CodeableConcept

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Resources:"Define"what"you"use

P"A"T"I"E"

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Codes"within"Codes

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Cardinality

0..0 Not$used

0..1 Optional

0..* Optional$multiple

1..1 Required

1..* At$least$one [{"Address}",]

“String”"Boolean"Integer

{"CodeableConcept"}

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Building"a"FHIR"Requesthttps://fhir.bbonfhir.com:8080/"fhir@p/"Patient/"{123456}"?parameters"[_id=123456]&"[date=>2015@02@14&date=<2015@06@30]&"[name:exact=Eve]&"[_format=json|xml]

Base@url

resourceTypeidhttps://www.hl7.org/fhir/search.html

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FHIR"Interactions• Read""

– GET"https://example.com/path/{resourceType}/{id}"• Search""

– GET"https://example.com/path/{resourceType}?search"parameters..."• History"

– GET"https://example.com/path/{resourceType}/{id}/_history"• Operation"

– GET"https://example.com/path/{resourceType}/{id}/${opname}"• Create>"

– POST>https://example.com/path/{resourceType}$• Update>

– PUT>https://example.com/path/{resourceType}/{id}"• Delete>"

– DELETE>https://example.com/path/{resourceType}/{id}>• Transaction>

– POST>https://example.com/path/>>• (POST>a>transaction>bundle>to>the>system)

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Implementing"FHIR

• Identify"code"sets"• Publish"codeable"concepts"• Map"fields"to"Profile/Resource"elements"• Define"Legacy@FHIR"Integration"

– Real"time"query"– Batch"ETL"

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Links"to"know…

• http://[email protected]/index.html"• https://github.com/jamesagnew/hapi@fhir

Explanation of Benefit

HealthCare’s Great Oxymoron

Proctology Exam for your wallet?

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A New FHIR EOB Resource

What is it?@ekivemark

Patient focused

Self-contained

Include reference Identifiers

Include patient profile subset

EOB = Adjudicated claim

One claim = One EOB

EOB has a GUID

The EOB

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DEMO/TOUR

BlueButtonOn

FHIR #BBonFHIR@ekivemark

BlueButtonOn

FHIR #BBonFHIR@ekivemark

BlueButtonMore than

Claims #BBonFHIR@ekivemark

BlueButtonMore than

Claims #BBonFHIR@ekivemark

BlueButtonMore than

Claims #BBonFHIR@ekivemark

BlueButtonMore than

Claims #BBonFHIR@ekivemark

BlueButtonMore than

Claims #BBonFHIR@ekivemark

You Can Help…

@CMSGOV I Support #BlueButton On #FHIR to @GetMyHealthData

/cc:@N_Brennan @ekivemark #NOPressure

@ekivemark #BBonFHIR #NoPressure

Help improve

the codebase on

GitHub

Do you want a

Sneak Peak?@ekivemark

dev.bbonfhir.com@ekivemark

Working on OAuth2…

Client Facing Application

dev.bbonfhir.com@ekivemark

dev.bbonfhir.com@ekivemark

Follow our progress, join us and contribute

• Structured File Formats:• ( https://github.com/ekivemark/claims )

• BlueButton Text to JSON Converter:• ( https://github.com/ekivemark/python-bluebutton )

• BlueButton On FHIR• ( https://github.com/ekivemark/bbofuser )

• Developer Code of Honor:• ( http://2.healthca.mp/1GjOUsY )

• HL7 - FHIR• ( http://www.hl7.org/implement/standards/fhir/http.html )

@ekivemark

@ekivemark

Mark Scrimshire HHS Entrepreneur-in-Residence (CMS)

@ekivemark http://ekivemark.com

[email protected] 703.623.2789